All-ceramic resin-bonded bridges. A 3-dimensional finite-element analysis study.

Resin-bonded fixed partial dentures (FPD) with a metal framework have some disadvantages: a grey shimmer of the metal wings through the abutment teeth, a higher corrosion rate, and an allergenic potential of the non-precious alloys used. The Al2O3 ceramic In-Ceram seems to be strong enough to serve as a framework for resinbonded all-ceramic FPDs. Because of the fact that ceramic wings often don't have enough inter-occlusal space, a new preparation design was developed. The objective of this study was to determine the influence of load orientation (45 degrees and 60 degrees) and the design of the interproximal connector on the stress distribution in the bridges. A 3-dimensional finite-element model was developed to simulate the anatomical situation. The biting force was assumed as 250 N and oriented in oro-buccal direction. The loading-point was palatal 1.5 mm beneath the incisal edge. It was found that stress generally increased with an angle of the biting force of 60 degrees. A small interdental connector (3 mm height) and/or strong interdental separation resulted in stresses of up to 455 MPa (45 degrees) or 534 MPa (60 degrees). Less separation with rounded edges and a higher connector (4 mm) reduced the stress to 122 MPa (45 degrees) and 143 MPa (60 degrees). Due to an average tensile strength of In-Ceram at 340-400 MPa, an all-ceramic resin-bonded FPD may only be recommended if the height of the connector could be minimum 4 mm. Rounded edges and little interdental separation are significant for stress reduction.